(fun fact how I remeber alkolosis vs acidosis w/ pt how vomit and shit, if it comes out the ASS it is ASSidosis, if out the mouth its just he other)

20

Nutritional Disorders: Anesthetic Implications

Intraop:

what should you be vgalent for in these individuals

Abnormal ECGS

Prologed QT

multi organ failure

21

Nutritional Disorders: Anesthetic Implications

Intraop

what medicatio are these pt's specifically sensitive to?

reversal for NMBD

22

Nutritional Disorders: Anesthetic Implications

Intraop:

What are 2 important task in these pt's?

HYDRATE

NGT/OGT gastroporesis (may want to place prior to induction)

23

Malabsorption Syndromes:

The ______ _______ does most the digesting of the foods we eat?

small intestines

24

Malabsorption Syndromes:

if you have a malabsorption Syndrome your ____ _____ connot absorb nutrients from food

Small intestine

(cathing on to a theme here?)

25

Malabsorption Syndromes:

What causes Malabsorption Syndromes?

Celiac disease

Lactose intolerance

Short Bowel

Whipple disease (rare bacteria infection0

Genetic diseases

Certain Medications

26

Malabsorption Syndromes:

what are 3 classifications of malabsorption syndromes

Malnutrition

Micronutrient Deficiences

Vitamin deficiencies

27

Malabsorption Syndromes:

Which subtype is defined as an altered metabolism due to an imbalance of intake and nutrient dense food resulting in loss of body mass or a deficiency in energy, protein, and other nutrients which cause measurable adverse effects

Malnutrition

28

Malabsorption Syndromes: Malnutrition

Malnutrition is a meddically distinct syndrome that is responsive to caloric support provided by _____ or _____ nutrition

enternal

or

TPN

29

Malabsorption Syndromes: Malnutrition

what are major causes of malnutrition in hospitals

N/V

Trauma

Inflammatory disease

Loss of appetite

Mechanical obstruction

30

Malabsorption Syndromes: Malnutrition

what are the SE of malnutrition

reduced Muscle strength

Hypothermia

Loss of cardiac muscle

decreased CO, bradycardia, hypotension

Decreased GFR

Infection response weakened

Electrolyte inbalances

Higher concentrations of water

31

Malabsorption Syndromes: Malnutrition

Malnurished pt's are identifeied by what?

Serum albumin concentration < 3g/dL

Transferrin Levels below 200 mg/dL

32

Malabsorption Syndromes: Malnutrition

malnutrition is associated w/ increased morbidity and mortality due to what mpaired symptoms?

Respiratoy

CV

Renal

Immune response

33

Malabsorption Syndromes: Malnutrition

an average adult requires how many calories daly to mantain basal energy levels

1500-2000

34

Malabsorption Syndromes: Malnutrition

What are 4 main events that can increase the caloric requirement? and for fun by how much?

Increase in Body temp (1 degree C=15% increase)

Multiple fractures (25% increase)

Major Burns (100% increase)

large tumor (100% increase)

35

Malabsorption Syndromes: Malnutrition

Preop

it is reccomended that pt's who have lost more than ____% of their body weight, they should be treated nutritionally before undergoing elective sx

20%

36

Malabsorption Syndromes: Malnutrition

Preop

Provision of nutritional support for ___ days before sx decreases the postoperative complications, especially in pts w/ gastrointestinal Ca and elderly pt's undergoing sx for hip fxs

7 days

37

Malabsorption Syndromes: Malnutrition

Preop

why are antibiotics given prophylacticly in these pt's

b/c changes in GI flora increases the susceptibility to infections

38

Malabsorption Syndromes: Malnutrition

Intraop

what are some important interventions for these individuals?

Care positioning (loss of body mass)

Maintain Body temp (bair hugger)

Hydrate

Sympathomemetics (bp)

expect a bad response to hypoxia and hypercarbia (due to decreased Muscle mass of respiratory muscles)

39

Malabsorption Syndromes: Malnutrition

Postop

why are they difficult to wean from vent?

decreased muscle mass and function

Prone to coughing

40

Micronutrient Deficiencies: Vit B12

the most significant effects of B12 def are seen in what system?

Nervous system

41

Micronutrient Deficiencies: Vit B12

treatment for B12 def

oral B12

increase foods high in B12

42

Micronutrient Deficiencies: Vit B12

what is recomended intake of Vit B12

10-15mcg/day

43

Micronutrient Deficiencies: Vit B12

for food malabsorption induced Vit B12 deficiency what is the recomended replacement dose?